The clinical and economic burden of communityonset complicated skin and skin structure infections in Korea

Yong Kyun Cho,Heung Jeong Woo,Shin-Woo Kim,In-Gyu Bae,Young Goo Song,Hee Jin Cheong,Hyuck Lee,Sang Hoon Han,Hee Jung Choi,Chisook Moon,Seong Yeol Ryu,Jian Hur,Jacob Lee,Yu Mi Jo,Young Joo Kim 대한내과학회 2020 The Korean Journal of Internal Medicine Vol.35 No.6

Background/Aims: To investigate epidemiologic characteristics, clinical and economic burdens, and factors associated with mortality in complicated skin and skin structure infection (cSSSI) patients in Korea. Methods: A retrospective, observational, nationwide study was conducted between April to July 2012 at 14 tertiary-hospitals in Korea. Eligible patients were hospitalized adults with community acquired cSSSI, who underwent surgical intervention and completed treatment between November 2009 and October 2011. Data on demography, clinical characteristics, outcomes and medical resource utilization were collected through medical record review. Direct medical costs were calculated by multiplying quantities of resources utilized by each unit price in Korea. Results: Of 473 patients enrolled, 449 patients (except 24 patients with no record on surgical intervention) were eligible for analysis. Microbiological testing was performed on 66.1% of patients and 8.2% had multiple pathogens. Among culture confirmed pathogens (n = 297 patients, 340 episodes), 76.2% were gram-positive (Staphylococcus aureus; 41.2%) and 23.8% were gram-negative. The median duration of hospital stay was 16 days. Among treated patients, 3.3% experienced recurrence and 4.2% died in-hospital. The mean direct medical costs amounted to $4,195/ person, with the greatest expenses for hospitalization and antibiotics. The in-hospital mortality and total medical costs were higher in combined antibiotics therapy than monotherapy (p < 0.05). Charlson’s comorbidity index ≥ 3, standardized early warning scoring ≥ 4, sub-fascia infections and combined initial therapy, were all found to be associated with higher mortality. Conclusions: Korean patients with community-onset cSSSI suffer from considerable clinical and economic burden. Efforts should be made to reduce this burden through appropriate initial treatment.

아파트主婦의 이웃關係 硏究 : On the Neighbororing of Housewives in Apartments 生活空間의 構造的 理解를 위한 接近

愼鏞在,金鐘仁 계명대학교 산업기술연구소 1984 産業技術硏究所 論文報告集 Vol.6 No.-

In this paper, some factors in neighboring between apartment residents(housewives) are distinguished through social survey in order to understand the social structure of living space. The intensity of neighoring, its priority, extent, formality, and occasions for it were compared between two social classes. 1) The maximum number of neighbors known to a family in a moderate and middle income housing estates was found to be five. The same number is reported for an American sample of married women as well as a British working class single family. 2) The number of neighbors is thought to be depending on how long people have lived in the same place, on how residentially stable the area is, on what types of housing they live in, on proximity (propinquity) between them, and on their social backgrounds: current income, style of life, family composition (eg. whether they have younger children of their own or not), tastes(for social relationships), and experiences. 3) As Gans put it up, propinquity brought neighbors into contact, but it was mainly because of homogeneity that this contact was maintained on a positive basis. 4) Seen with respect to social classes, moderate-income families were higher in number of contacting neighbers than middle-income families. However, this tendency was reversed when intensity and cause of neighbering was taken into consideration. 5) 85 percent of respondents were contacting formally (casually) with neighbors under five. This high tendency of percentage was sustained to the level of visiting relationships as far as moderate-income family is concerned.

農家所得 增進을 爲한 有實樹 植栽의 經濟性 分析

愼鏞仁 全南大學校 農漁村開發硏究所 1974 農業科學技術硏究 Vol.8 No.-

In recent years, the farmers have shown a great concern on fruit tree plantation to increase farm bousehold income. The government is also promoting new establishment of crop-fruit tree villages, as one of Semawul (New village) Project. This paper is to investigate some theoretical grounds on the execution of the fruit tree plantation. The objects of this paper are (1) to provide data as a base year for a comparison after several years when the fruit trees grow matured enough to yield, and (2) to investigate problems regarding fruit tree plantation, In this study, the fruit tree: management is divided into two types of plantations, namely, regionalized and non-regionalized plantation. A sample, survey was conducted for the non-regionalized plantation where six sample villages were selected to enumerate all fruit trees. For the regionalized plantation, 12 chest nut-tree regions and 9 persimmon-tree regions, were investigated. The summary of the survey results are as follows. 1. As in Table 1, there are 16 kinds of fruit-trees planted in Chunnam area. 2. regarding the non-regionalized fruit-tree plantation, (1) The average number of fruit-tree per a farm house hold is 17.4. (2) The income per household is 10,759 won and net profit is 10,214 won. (3) The cash income is 7,340 won. (4) The larger the farm size is, the bigger the fruit-tree income is. 3. ln non-regionalized plantation, The farm income attributed to fruit-tree is 3%, that is, the contribution, of fruit-tree to the total farm income is 3%. 4. With regard to regionalized plantation, (1) It is seen that the net profit of chest-net per plantation is 733,269 won (total area 5.6 chong-bo, 2,250 trees) and 130,359 won per chong-bo. (2) The profit of persimmon is 164,723 won per plantation (total area 0.4 chong, 173 trees) and 407.394 won per chong-bo. 5. The non-regionalized plantation shows the management cost only 20% of the cost of the regionalized plantation, and produces 70% of the product. This implies that the non-regionalized plantation is needed to put in more investment to increase the products. 6. In dealing with chest-nut, it was found that a large scale sale or a consignment sale in large cities was a more advanteous then a small scale sale in rural area. 7. In dealing with persimmon, it was observed that farms sold the persimmons as on the trees before matured at the price pf 650 won for 100 which is much lower than the normal market price 1,000 won. The 63% of the total amount of sale was under this way, which is to be improved in the future.

傳門大學 海洋土木科 敎育課情 開發硏究

林秉龍,鄭營采,申文燮,李東周,張仁奎,金榮燮 군산대학교 1982 群山水産專門大學 硏究報告 Vol.16 No.1

To carry out the study on the curriculum development for the ocean civil department in junior college, we collected and analyzed data which are on the curriculum development or improvement of the inside and outside of the country. We also gathered the opinion through the inquiring paper investigation and the consultation to the industrial organization, concerned school and authorities during 6 months from May, 1981. In addition, we analyzed and compared the present curriculum of special civil and ocean civil department in junior college. On the basis of above methods, a result we made a model curriculum shown in Table 10. Under current trend and circumstances of the industrial society, the best way for the curriculum development is to make like the course curriculum. But, it is is difficult to make the course curriculums of the ocean cavil department at present. Because the ocean civil is a branch of general civil engineering, furthermore the oceanic industry of our country is not developed well. So, dividing the major subjects in four fields for operating the model curriculum flexibly with the characteristics of the community and college, we developed the suitable curriculum in junior college course, such as general basic field, special basic field related to the ocean, special basic field related to the general civil and application field. We also tried to entensify the subjects of general basic field, special basic field related to the ocean, and to simplify the number of subjects in the model curriculum. Of course we can't say this model curriculum is perfect. But we believe firmly that the results of this paper will be a help to another curriculum development or improvement study for the ocean civil department in junior college.

정신분열병 환자에서 가족력, 산과적 합병증 및 신체미세기형의 관련성에 관한 연구

안용민,김용식,정희연,신지용,윤세창,배안,이중서,주은정,이창인 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.2

연구목적 : 저자들은 태생기 동안에 받는 유전외적 요인, 즉 환경적 요인이 산발성 정신분열병 환자들의 발병에 크게 관여할 것이라고 가정하였다. 이를 검증하기 위하여 형제 중 1인 이상이 발병하여 가족력을 분명히 알 수 있는 정신분열병 환자군(이하 형제 환자군)과 가족력이 없는 산발성 정신분열병 환자군(이하 산발성 환자군) 및 정상대조군을 대상으로 산과적 합병증, 신체미세기형 및 정신분열병의 임상 양상을 비교하였다. 방 법 : 연구 대상은 형제 환자군 43명(남 22명, 여 21명), 산발성 환자군 43명(남 23명, 여 20명), 정상대조군 43명(남 20명, 여 23명)이었다. 산과적 합병증은 Lewis 척도를 이용하여 평가하였고 신체미세기형은 Waldrop 척도를 이용하여 측정하였다. 임상 양상으로서 발병 연령, 병전 기능 수준, 정신병리, 약물에 대한 반응, 회복시의 전반적 기능 수준, 지연성 운동장애의 유무를 평가하였다. 결 과 : 정상대조군과 정신분열병 환자군 전체를 비교하였을 때 산과적 합병증과 신체미세기형의 총점과 각 소항목의 점수에 차이가 없었다. 산발성 환자군과 형제 환자군을 비교하였을 때 산과적 합병증의 전체 점수에서는 유의한 차이가 없었으나, 출생 당시에 태아가 받은 스트레스 항목의 점수가 산발성 환자군에서 유의하게 높았다. 신체미세기형에서는 전체 점수 및 입의 미세기형 점수가 산발성 환자군에서 유의하게 높았다. 신체미세기형의 전체 점수가 4점 이상인 환자수도 산발성 환자군에서 높은 경향성을 보였다. 산과적 합병증과 신체미세기형 사이의 상호 연관성은 찾을 수 없었다. 정신분열병의 임상 양상 중에서는 Krawiecka 척도의 총점 및 양성 증상 점수와 회복시의 전반적 기능 수준만이 형제 환자군에 비해 산발성 환자군에서 유의하게 높았다. 성별에 따라서는 형제 환자군에서 남자 환자의 산과적 합병증이 유의하게 높았다. 결 론 : 본 연구를 통해 산과적 합병증 및 신체미세기형 연구가 정신분열병의 원인을 규명하기 위한 유용한 방법임이 시사되었지만, 가족력, 산과적 합병증 및 신체미세기형의 관련성에 대해서는 분명한 결론을 내리지 못하였다. The authors hypothesized that sporadic schizophrenic patients had more chances of receiving environmental insults during the fetal neural development compared with familial schizophrenics. We tested our hypothesis by comparing obstetric complications(OCs), minor physical anomalies(MPAs) and other clinical features, and examining the correlation between OCs and MPAs in schizophrenic patients who had one or more sibling with schizophrenia(sibling group) and sporadic schizophrenics(sporadic group) and normal controls. OCs were evaluated by the scale of Lewis, and MPAs were measured by the Waldrop scale. There were no significant difference in OCs and MPAs between schizophrenic and control groups. Sporadic group had significantly higher fetal distress, total Waldrop score and Waldrop score for mouth than sibling group. And there was a tendency that the number of subjects having the Waldrop score over 4 points was greater in the sporadic group. No significant correlation was observed between CCs and MPAs. The scores of initial psychopathology and post-treatment functioning were much higher in the sporadic group, but the other clinical feature showed no difference. Although male patients had more OCs than female patients in sibling group, no sex difference were observed as a whole. Our results suggest that, if the methodological weakness were complemented, OCs and MPAs would be useful tools in the search for the cause of schizophrenia.

위등세모근 통증유발점이 있는 목 통증 환자의 압력 통각 역치 및 근활성도에 대한 뉴렉 기법의 즉각적인 효과

하용목(Yong-Mok Ha),어인준(In-Joon Uh),손정호(Jung-Ho Son),신선실(Sun-Shil Shin) 한국임상움직임치료학회 2023 한국임상움직임치료학회지 Vol.3 No.2

Background Neck pain is a prevalent condition affecting 45-54% of the population, with chronic symp-toms experienced by 14% of individuals, leading to significant productivity reduction and healthcare costs. Therapeutic exercise, particularly active interventions, has shown efficacy in reducing chronic neck pain. The Neurac (Neuromuscular Activation) technique aims to enhance active movement and create pain-free movement. Objectives To investigate the immediate effects of Neurac technique on pressure pain threshold (PPT), resting muscle activity measured through surface electromyography (sEMG), and pain level assessed using the Visual Analogue Scale (VAS) in individuals with chronic neck pain. Methods Fifteen adult participants with chronic neck pain were recruited from a university in Busan, South Korea. Neurac technique, involving four specific neck, and shoulder exercises using a Redcord Trainer, PPT, resting muscle activity, and pain level (VAS) were evaluated before and after the Neurac technique intervention. Results Following the Neurac technique, participants demonstrated a significant increase in PPT (p < 0.001) and a significant decrease in pain level measured by VAS scores (p < 0.001), indicating reduced pain. However, no significant changes were observed in resting muscle activity during the rest period (p = 0.616). Conclusions This study found that the Neurac treatment program effectively reduced pain and in-creased pressure pain threshold in individuals with neck pain associated with trigger points in the upper trapezius muscle, although no significant changes in muscle activity at rest were observed.

장애인 공동체에 대한 연구 : Camphill을 중심으로 Docused on Camphill

이인영,신용웅 한국장애인재활협회 2004 재활복지 Vol.8 No.2

본 연구는 지적능력에 결함을 가진 발달장애인의 부모 사후 자녀의 영속적인 삶의 질에 대한 관심에서부터 출발하여 그 대안으로 특수교육과 사회복지분야에서 실험적인 모델로 관심을 끌고 있는 '장애인공동체'를 주제로 하고 있다. 특히 전 세계 20여개국에 100여개로 활성화되고 있는 Camphill 중 아일랜드 더스게릭 캠프힐(Duffucarrig Camphill)에 단기자원봉사활동을 토대로 문헌자료를 보강하여 진행하였다. 먼저, 장애인공동체의 대표적 모델로 손꼽히는 캠프힐의 성격을 규명하기 위해 캠프힐의 철학과 가치, 설립배경 및 과정, 위치와 규모, 구성원, 재정과 운영을 분석해보았다. 분석결과 캠프힐은 자급자족적 요건만을 충족하지 못할 뿐 그 외 공동체생활의 요소라 할 수 있는 성원 공동의 가치와 덕목 실현, 지역을 기반으로 하는 공동생활, 인격적 친밀감, 운영규칙에 의한 자치 등을 발견할 수 있었다. 또한 참여, 접근, 존재, 생산, 소비 등 5가지의 Segal & Aviram(1978) 다차원적 접근으로 캠프힐 내 생활, 생산, 여가 및 문화, 소비, 건강 및 의료, 자기결정을 분석해본 결과, 단지 물리적 통합이 아닌 지역사회내의 참여부분에 강점을 갖는 것으로 분석되었다. 또한 가정이나 지역사회안에서 대인관계의 원활성, 타인으로부터의 존중감, 개인의 취향이나 개별성 보장 등의 영역에서도 삶의 질을 담보하고 있었다. 이상의 연구를 통해 장애인공동체로서 캠프힐은 첫째, 발달장애인의 영속적인 삶을 위한 하나의 대안적 모델로 둘째, 발달장애인의 사회통합 뿐 아니라 삶의 질을 중시하고 있으며 셋째, 발달장애인의 복지를 바라보는 관점을 삶의 질 측면으로 끌어올리고, 지속적 삶의 질을 위해서 어떠한 자원들이, 어떻게 결합되어야 하는지에 대한 모델이 된다는 점에서 큰 시사점을 던져준다 할 것이다. The theme of this study is on 'the Community of People with Disability' which attracts our attention to as an alternative measure for the permanent quality of lives of children with developmental disabilities after their parents' death, as well as an experimental model in the fields of special education and social welfare. Especially, this article deals with short-term voluntary activities in Duffucarrig Camphill in Ireland among hundred Camphills, which have been actively run in over twenty countries, including its literature study. First of all, in order to clarify the characteristics of Camphill, which is well-known for a representative model among communities of people with disabilities, the philosophy and values of Camphill, its foundation background and process, location and scale, its members, and its finance and management are analyzed. As a consequence of the analysis, we can find the components of community lives, such as the common values of members, their realization of virtues, community lives based on the locality, humane intimacy, autonomy by its management rules, etc., except not satisfying a self-sufficiency component. Also, after analyzing life, production, leisure and culture, consumption, health and medicine, self-determination, etc, in Camphill through multidimensional approaches which are composed of five elements, such as participation, approch, existence, production, and consumption by Segal & Aviram(1978), it has strength in community participation, not only physical intergration. Besides, the quality of their lives are assured in the areas of good interpersonal relations, respectfulness by others, the right of choice, individual taste, individuality, etc. Thus, Camphill, as a coummunity of people with disabilities, can be described as follows: First, it can be a alternative model for the permanent lives of people with developmental disabilities: Second, it focuses on the quality of their lives as well as the social integration of people with developmental disabilities: Third, it gives suggestions in that it raises perspectives on the welfare of people with developmental disabilities up to the dimension of the quality of their lives, and can be a model to show what kind of resources should exist, and how they should be combined in order to guarantee the continual quality of their lives.

Comparison of clinical characteristics and prognosis of pneumocystis jirovecii pneumonia in patients with immunocompromised and non-immunocompromised conditions

( Hong-joon Shin ),( Min-seok Kim ),( Bo Gun Kho ),( Ha Young Park ),( Tae-ok Kim ),( Cheol-kyu Park ),( Yong-soo Kwon ),( In-jae Oh ),( Yu-il Kim ),( Sung-chul Lim ),( Young- Chul Kim ) 대한결핵 및 호흡기학회 2019 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.127 No.-

Background: Pneumocystis jirovecii pneumonia (PCP) is a fatal respiratory infection frequently associated with immunocompromised (IC) conditions. Although PCP has been reported in non-immunocompromised (non-IC) patients, however, few studies have been conducted. This study was aimed to compare the clinical characteristics and prognosis of PCP in IC and non-IC patients. Methods: We retrospectively analyzed patients who were suspected of having PCP with polymerase chain reaction (PCR) test positive for Pneumocystis jirovecii from January 2013 to May 2019. IC group was classified into human immunodeficiency virus (HIV), hematologic, solid organ tumor, rheumatologic and immunosuppressive agent group. Results: A total 192 PCP cases including 176 IC cases and 16 non-IC cases were analyzed. Patients were older in the non-IC group compared with the IC group (72.5 vs. 62.0, P=0.002). Hematologic malignancy was the most common (47.2%), followed by HIV (14.8%) in the IC group. The interval between test for PCP-PCR and PCP treatment was shorter in the IC group compared with non-IC group (0 [0-3] vs. 4.0 [2.2-7.7] days, P=0.001). In-hospital mortality was not significantly different between IC and non-IC groups (43.2% vs. 62.5%, P=0.189). Age (odds ratio [OR] 1.05; 95% confidence interval [CI] 1.02-1.09; P=0.002) and PaO₂/FiO₂ (OR 0.99; 95% CI 0.98-1.00; P=0.039) were the prognostic factors for in-hospital mortality in the multivariate logistic regression analysis. There was no significant difference between IC and non-IC group in 6-month survival. However, HIV group had better 6-month survival compared with non- IC group in the subgroup analysis (Hazard ratio 0.16; 95% CI 0.05-0.53; P=0.003]. Conclusion: Patients with PCP in non-IC group were older than IC group, and had similar prognosis as other IC group except HIV group.

National survey of Korean hepatobiliary-pancreatic surgeons on attitudes about the enhanced recovery after surgery protocol

Sang Hyun Shin,Woo-hyoung Kang,In Woong Han,Yunghun You,Huisong Lee,Hongbeom Kim,Woohyun Jung,Yong Chan Shin,Jin Seok Heo 한국간담췌외과학회 2020 Annals of hepato-biliary-pancreatic surgery Vol.24 No.4

Backgrounds/Aims: The purpose of this study was to investigate attitudes regarding the Enhanced Recovery After Surgery (ERAS) protocol of hepato-biliary-pancreatic (HBP) surgeons in Korea and the extent to which they use the protocol for perioperative management. Methods: An online survey was conducted among members of the Korean Association of Hepato-Biliary-Pancreatic Surgery (KAHBPS) for eight weeks beginning on August 2019. The questionnaire, which was written in Korean, was based on the latest ERAS guidelines. Total responses were collected from 127 surgeons. Results: Of the 127 total respondents, the largest proportion (44.9%) were working in Seoul. In terms of established in-hospital clinical pathways (CP), 19.7% of the participating surgeons had and followed a CP in pancreaticoduodenectomy (PD) and 21.3% in hepatectomy. Regarding the ERAS protocol for each surgery, four items (18.2%) regarding PD and seven items (35.0%) related to hepatectomy were followed by more than 50% of respondents. Conclusions: ERAS guidelines are one of the consensuses for better recovery in perioperative management of patients undergoing major surgeries and encompass the overall process of patient recovery including patient education, pain control, physiologic balance, and perioperative nutrition. A novel project is needed to successfully implement an evidence-based enhanced recovery strategy.

혈액 내 구리, 아연 및 ceruloplasmin 농도에 흡연, 음주 및 신체적 활동이 미치는 영향

홍연표,강은용,신인철,최병선,박정덕,장임원,박진완 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.4

Objectives : To investigate the influence of smoking, alcohol ingestion, and physical activity on copper and zinc in RBC and serum and serum ceruloplasmin, this study was performed in a cross-sectional study in 113 healthy men aged 20 to 40 years who had no symptomatic liver, heart, gastrointestinal, and other chronic diseases. Methods : At the men's entry into the study, blood samples were drawn from each subject and immediately centrifuged for analysis of copper, zinc, iron, ceruloplasmin, total cholesterol, and hematocrit. Each man completed a questionnaire that provided information on smoking, amount of alcohol intake, and physical activity. Partial regression analysis was performed on confounding variables such as age, body mass index, hematocrit, serum cholesterol, and serum iron. Results : In general linear models, adjustment for confounding variables did not show statistical differences, and there was only an increasing tendency in serum copper in heavy smoker(P=0.0678). There was no difference between high physical activity with mild smokers and lower physical with heavy smokers. Conclusions : This study suggested that copper, zinc and ceruloplasmin were not good biomarker for early effect by smoking, alcohol intake and physical activity in young adult. However, selection bias should be considered in evaluation of this result, and a large prospective study will be needed in advance on usefulness of copper, zinc and ceruloplasmin as a marker for risk factors and early change of atherosclerosis.